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Individual
TINA MARIE DAERR
Active
Individual
TINA MARIE DAERR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
SP017360
PA
363LF0000X
Family Nurse Practitioner
Primary
SP017360
PA
Other
Enumeration date
03/24/2017
Last updated
08/12/2020
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